Rosenthal T C, Siepel T, Zubler J, Horwitz M
Department of Family Medicine, School of Medicine and Biomedical Sciences, State University of New York at Buffalo 14215.
J Fam Pract. 1994 Apr;38(4):380-5.
Ultrasonography has become an increasingly important diagnostic tool, producing high-quality images at a low cost. However, except in obstetrics, ultrasonography has not been used for screening purposes in asymptomatic persons.
This prospective study included 189 patients on whom an abdominal ultrasound scan was performed by a family physician as part of a routine physical examination. During the 2-year follow-up period, the screening was evaluated by determining whether the ultrasound findings contributed to the patient's health care management.
Forty-two of the patients (22%) were found to have previously undiagnosed conditions. The most common findings were gallstones, urinary retention, and renal cysts. Six patients (3%) received treatment for the condition detected by the screening, but three of these patients received treatment only after they developed symptoms during the 2-year follow-up period. One patient developed symptoms for gallstones that may have been missed by the screening ultrasound. The internal and external reliability rates for the screening examination were 96% and 82%, respectively.
Ultrasound findings altered the treatment plan for 3% of the screened patients but was the sole factor leading to treatment in only 1.6%. Abdominal ultrasound can be performed accurately and at a reasonable cost by generalist physicians. Patient acceptance was high, and many reported feeling reassured by the ultrasound screening.
超声检查已成为一种越来越重要的诊断工具，能够以低成本生成高质量图像。然而，除了在产科领域，超声检查尚未用于无症状人群的筛查。
这项前瞻性研究纳入了189例患者，家庭医生对其进行腹部超声扫描作为常规体检的一部分。在为期2年的随访期间，通过确定超声检查结果是否有助于患者的医疗管理来评估筛查效果。
42例患者（22%）被发现患有此前未诊断出的疾病。最常见的检查结果是胆结石、尿潴留和肾囊肿。6例患者（3%）因筛查发现的疾病接受了治疗，但其中3例患者仅在2年随访期间出现症状后才接受治疗。1例患者出现了可能被筛查超声遗漏的胆结石症状。筛查检查的内部和外部可靠性率分别为96%和82%。
超声检查结果改变了3%筛查患者的治疗方案，但仅在1.6%的患者中是导致治疗的唯一因素。普通医生能够准确且低成本地进行腹部超声检查。患者接受度很高，许多人表示超声筛查让他们安心。
